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Clin Sci (Lond). 2017 Jun 1;131(12):1191-1206. doi: 10.1042/CS20160384.

Disease progression and regression in sporadic small vessel disease-insights from neuroimaging.

Author information

1
Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroscience, Radboud university medical centre, Nijmegen, the Netherlands.
2
Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroscience, Radboud university medical centre, Nijmegen, the Netherlands FrankErik.deLeeuw@radboudumc.nl.

Abstract

Cerebral small vessel disease (SVD) is considered the most important vascular contributor to the development of dementia. Comprehensive characterization of the time course of disease progression will result in better understanding of aetiology and clinical consequences of SVD. SVD progression has been studied extensively over the years, usually describing change in SVD markers over time using neuroimaging at two time points. As a consequence, SVD is usually seen as a rather linear, continuously progressive process. This assumption of continuous progression of SVD markers was recently challenged by several studies that showed regression of SVD markers. Here, we provide a review on disease progression in sporadic SVD, thereby taking into account both progression and regression of SVD markers with emphasis on white matter hyperintensities (WMH), lacunes and microbleeds. We will elaborate on temporal dynamics of SVD progression and discuss the view of SVD progression as a dynamic process, rather than the traditional view of SVD as a continuous progressive process, that might better fit evidence from longitudinal neuroimaging studies. We will discuss possible mechanisms and clinical implications of a dynamic time course of SVD, with both progression and regression of SVD markers.

KEYWORDS:

cerebral small vessel disease; dynamics; longitudinal; neuroimaging

PMID:
28566448
DOI:
10.1042/CS20160384
[Indexed for MEDLINE]

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